The effect of topical antibiotic use on the incidence of endophthalmitis after intravitreal injection

Abstract

Purpose: Evaluation of the effect of topical antibiotic use after intravitreal injection on the incidence of endophthalmitis. Materials and Methods: The files of patients who underwent intravitreal aflibercept, ranibizumab, bevacizumab and dexamethasone implants for the indications of diabetic retinopathy, age-related macular degeneration and retinal vein occlusion between April 2019 and August 2021 were retrospectively reviewed. Povidone-iodine prophylaxis was administered to all patients before injection. Patients who received topical antibiotic prophylaxis after injection were accepted as group 1; patients who did not receive topical antibiotic prophylaxis were classified as group 2. The groups were compared in terms of the incidence of post-injection acute endophthalmitis. Results: Post-injection endophthalmitis developed in 4 cases during the study period. Acute endophthalmitis developed in 2 eyes (0.08%) after 2444 intravitreal injections in group 1 where topical antibiotics were used. In the group that did not use topical antibiotics, 2 cases of endophthalmitis (0.05%) were encountered after 3620 intravitreal injections (p=0.189). Conclusion: There was no significant difference in the incidence of endophthalmitis between the two groups that received and did not receive topical antibiotics after injection. It was observed that microorganisms originating from the oral flora were a serious source of endophthalmitis.